Ask the treatment expert ... about incontinence briefs

There is no absolute “yes” or “no” answer. The decision to use incontinence briefs should be based on the resident's history, physical and assessment. Facility policies should be specific regarding the use of adult briefs and developed individually for each resident.

The care plan should include instructions and guidance regarding the use of incontinence briefs. The use of adult briefs should be discussed with family members and documented.

First, determine the level of continence prior to the current illness. An understanding of the type and severity of incontinence is necessary in order to provide rehabilitation services such as scheduled toileting programs or bowel/bladder retraining activities.

Several studies have pointed out that many individuals who were not incontinent prior to a hospitalization are discharged with a continence issue. The skilled nursing facility should be able to rehabilitate these residents to reach their prior level of function.

There can be health-related complications with incontinence briefs. These include an increased risk of pressure ulcers, incontinence-associated dermatitis and urinary tract infections. Psychosocial conditions, such as self–esteem and quality of life, should also be evaluated.

The provider must first consider the dignity of the resident. Appropriate use may enhance the individual's quality of life if used to prevent incontinent episodes during social situations such as activities and meals, or to enable participation during therapy sessions. Of course, when the resident is assisted to bed for a significant period of time after activities, briefs should be replaced with incontinence pads to prevent skin complications.

About 60,000 elderly or disabled Medicaid recipients in Louisiana are being told they should expect to lose their benefits in July, and advocates say more than a quarter of them could be forced out of the long-term care facilities they call home.